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Original research
Development of Rehabilitation of Eclectic Cognitive Functioning Post-Traumatic Brain Injury to Retrain and Restore Attention, Concentration, Memory and Executive Functions (RETRACE)
  1. Sakshi Chopra1,
  2. Sumit Sinha2,3,
  3. Senthil S Kumaran4,
  4. Harsimarpreet Kaur1,
  5. Ravindra Mohan Pandey5,
  6. Ashima Nehra1
  1. 1Division of Clinical Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  3. 3Department of Neurosurgery, Paras Hospitals, Gurgaon, India
  4. 4Department of Nuclear Magnetic Resonance, All India Institute of Medical Sciences, New Delhi, India
  5. 5Department of Bio-Statistics, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Ashima Nehra, Clinical Neuropsychology, All India Institute of Medical Sciences, New Delhi 110029, India; ashimanwadhawan{at}gmail.com

Abstract

Background Traumatic brain injury (TBI) incapacitates nearly 3.5 million Indians and can result in a host of physical, cognitive, social, emotional and behavioural problems. Neuropsychological rehabilitation (NR) aids in amelioration of these deficits. As people with low literacy levels represent a significant proportion of the world, specific cognitive rehabilitation modules for such populations are indispensable. A standardised, economical NR intervention may assist in faster recovery.

Methods The study was initiated after obtaining institute ethics approval and the Clinical Trials Registry – India clearance. A 6-week indigenised literacy-free NR intervention Rehabilitation of Eclectic Cognitive Functioning post Traumatic Brain Injury to Retrain and Restore Attention, Concentration, Memory and Executive Functions (RETRACE) was developed. This intervention targeted areas of memory, attention and concentration, executive functioning, and response inhibition. It was standardised on 50 healthy controls and 18 patients. Prior to recruitment, a written informed consent was obtained from each patient, their primary caregiver and the healthy controls.

Results Individuals were divided into four groups based on their education levels: illiterates; 1–9 years, 10–14 years; and >15 years. All the outcomes for each of the four cognitive domains in the intervention did not have any significant difference for errors committed among the healthy controls with respect to different levels of education. The performance of patients with the healthy controls on all the four cognitive domains revealed a significant difference in each.

Conclusions RETRACE covers major areas of cognitive impairment that affects an individual’s social, vocational and personal quality of life after brain injury. This intervention is feasible to administer and may help alleviating cognitive complaints after brain injury in low literate or mixed cultural populations. RETRACE is simple to score and can be done easily at the patient’s home under the supervision of the patient’s caregiver. Further study of its efficacy in a randomised trial is already underway.

  • accessible
  • affordable
  • inventions
  • neurology
  • trauma
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Footnotes

  • Contributors SC planned the study, collected data, carried out statistical analysis and wrote the manuscript. SS planned the study, data acquisition and interpretation of data. SSK planned the study, collected and interpreted data. HK collected and analysed data. RMP planned the study and analysed data. AN planned the study, conception and reviewed the manuscript.

  • Funding This study was funded by All India Institute of Medical Sciences PhD Fellowship.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was cleared by the institute ethical committee (IESC/T-14/03.01.2014).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article. All deidentified participant data are available.

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